Active NPI
Gary Vertula
- Professional Counselor
- Bridgeport, CT
National Provider Identifier
1780130674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 001749
- Practice address
- 260 Robin St
Bridgeport, CT 06606-4440 - Phone
- (203) 394-2595
- Fax
- (203) 332-1629
- NPI assigned
- Aug 30, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 001749 | CT | Primary |
Addresses
Primary practice location
260 Robin St
Bridgeport, CT 06606-4440
Mailing address
260 Robin St
Bridgeport, CT 06606-4440
Phone (203) 394-2595
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001749 | CT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472515200000",
"number": "1780130674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 ROBIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066064440",
"telephone_number": "203-394-2595",
"fax_number": "203-332-1629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 ROBIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066064440",
"telephone_number": "203-394-2595",
"fax_number": "203-332-1629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERTULA",
"first_name": "GARY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-30",
"last_updated": "2016-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "001749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.